Becker's ASC Review

12 ASC MANAGEMENT California ASC could drop contract with Anthem over proposed rate decrease: 6 details By Angie Stewart M onterey (Calif.) Peninsula Surgery Center plans to terminate its contract with Anthem Blue Cross on March 18 if the entities can't agree on new contract terms by then, according to a Feb. 18 announcement. Six details: 1. MPSC began negotiating with Anthem in September 2019, proposing what it called "modest rate increases" under which it would remain the lowest-cost local Anthem provider for nearly all procedures. 2. MPSC said the rate increase was necessary to keep up with the cost of doing business as Monterey's only multispecialty outpatient surgical center. 3. Anthem responded by proposing a rate reduction. Around the same time Anthem reported 13 percent revenue growth in 2019, according to MPSC. An Anthem Blue Cross spokes- person told Becker's ASC Review that the costs for services provided by MPSC are already higher than the state average. 4. If the mid-March deadline passes without an agreement on contract terms, MPSC will continue treating Anthem beneficiaries who already have appointments or are receiving care at the facility. For other Anthem enrollees, MPSC will be out of network. 5. According to MPSC CEO Tom Wilson, Anthem is using its market share to force independent providers to accept lower payments. "is is an unwise business strategy, as independent sur- gery centers like MPSC provide excellent surgical services at a lower cost," he said. "is short-sighted power play will result in significantly higher costs for both Anthem and their members." 6. An Anthem Blue Cross spokesperson provided the follow- ing statement to Becker's ASC Review: "It's disappointing Monterey Peninsula Surgery Center would signal its intent to terminate its contract with us rather than focus on engaging in meaningful negotiations that would help protect affordability for our consumers. Given MPSC's unfortunate decision, Anthem is acting now to ensure that in the event a new agreement is not reached be- fore March 18, there is a seamless transition for our members and participating physicians, and there are no gaps in care. Anthem has a broad network of high-quality care providers throughout the region, and we will continue to offer nation- ally recognized, high-quality healthcare alternatives for our members." n Florida ASC files for bankruptcy: 3 details By Laura Dyrda Central Palm Beach Surgery Center in West Palm Beach, Fla., filed for bankruptcy Jan. 28. Three key details: 1. The surgery center filed for chapter 11 bankruptcy in the Southern District of Florida. 2. The surgery center estimated its assets at $7.1 million and estimated its liabilities at $12.2 million. 3. The estimated value of the center's personal property and inventory is $252,385. n Oklahoma ASC begins performing cardiac procedures — 3 insights By Eric Oliver O klahoma City-based CardioVascular Health Clinic is performing percutaneous coronary intervention as an outpatient service following CMS' decision to allow the procedure to be performed in an outpatient setting, The Oklahoman reports. What you should know: 1. Most Medicare recipients will be eligible to have the proce- dure performed in an ASC. 2. CMS believes moving 5 percent of all coronary interventions to ASCs would save Medicare $20 million and would reduce beneficiary copays by $5 million in 2020. 3. CardioVascular Health Clinic is the only ASC in Oklahoma that performs specialized cardiac procedures. n Physician-owned orthopedic hospital expanding Ohio facility By Rachel Popa Crystal Clinic Orthopaedic Center, a physician-owned hospital network, is expanding its facility in Kent, Ohio. The expansion will double the size of the facility, adding exam rooms and physical therapy space. The project will be com- pleted in two phases, with the first ending this summer and the second in the fall. The second phase will add same-day, walk-in care at the clinic. In the last year, Crystal Clinic has opened two clinics in North- east Ohio and broken ground on an orthopedic hospital set to open next year. n

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